Individual
MS. DIANNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
317 N HUDSON ST, ALTUS, OK 73521-3709
(580) 482-2809
(580) 482-2820
Mailing address
PO BOX 175, ALTUS, OK 73522-0175
(580) 482-2809
(580) 482-2820
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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